Jiang Fonda, Torgerson Troy R, Ayars Andrew G
University of Washington, Seattle, WA USA ; Center for Allergy and Inflammation UW Medicine at South Lake Union, 850 Republican Street, Seattle, WA 98109-4725 USA.
University of Washington, Seattle, WA USA ; Seattle Children's Hospital, Seattle, WA USA.
Allergy Asthma Clin Immunol. 2015 Sep 29;11:27. doi: 10.1186/s13223-015-0092-y. eCollection 2015.
Primary immunodeficiency disease (PIDD) with hypogammaglobulinemia is characterized by recurrent and severe bacterial infections and IgG replacement is the standard of care in many of these patients. Health-related quality of life (HRQOL) is becoming increasingly recognized as a factor that affects patient well-being and treatment preferences. In an effort to better understand what factors affect HRQOL in patients with PIDD, we reviewed the published literature that used standardized instruments for the measurement of HRQOL. We investigated HRQOL in PIDD patients compared with normal controls and patients with other chronic diseases; we also investigated the impact of treatment administration on patient satisfaction. The most commonly encountered health-related quality of life instruments were the child heath questionnaire parental form 50, short form 36, PedsQL 4.0, Lansky's play performance scale, and Life Quality Index. Patients with PIDD scored significantly lower on many of the instruments compared with normal controls. Also, while it appears that many patients appreciate home-based and subcutaneous IgG replacement therapy, patient satisfaction ultimately involves various clinical factors and individual patient preferences. By further analyzing what factors impact HRQOL, therapy adjustments can be made to maximize patient well-being and minimize disease impact on daily functioning.
伴有低丙种球蛋白血症的原发性免疫缺陷病(PIDD)的特征为反复发生严重细菌感染,对许多此类患者而言,IgG替代疗法是标准治疗方法。与健康相关的生活质量(HRQOL)日益被视为影响患者幸福感和治疗偏好的一个因素。为了更好地了解哪些因素会影响PIDD患者的HRQOL,我们回顾了已发表的使用标准化工具测量HRQOL的文献。我们研究了PIDD患者与正常对照以及其他慢性病患者相比的HRQOL情况;我们还研究了治疗给药方式对患者满意度的影响。最常使用的与健康相关的生活质量工具包括儿童健康问卷家长版50项、简明健康调查问卷36项、儿童生活质量量表4.0版、兰斯基游戏表现量表和生活质量指数。与正常对照相比,PIDD患者在许多工具上的得分显著更低。此外,虽然似乎许多患者认可居家和皮下IgG替代疗法,但患者满意度最终涉及多种临床因素和个体患者偏好。通过进一步分析哪些因素会影响HRQOL,可以调整治疗方法,以最大限度地提高患者幸福感,并尽量减少疾病对日常功能的影响。